Prevention of carcinoma cervix: role of Pap smear screening

This study was undertaken to evaluate the prevalence of Cervical precancerous and Cancer pick up by single pap smear test. A prospective study of pap smear test of three years duration 2000-2002 in Obstetrics and Gynecology department, NMCTH, Kathmandu. A total 800 cases were included Maximum number of patients are in the age group of active reproductive period (21-40 yr) with higher rate of an abnormal smear in Brahmin ethnic group. The main complaints are of lower abdominal pain and white discharge per vaginum. The main cervical pathology is cervicitis, cervical erosion and cervical hypertrophied with bleeding on touch. 4.8% of the patients had abnormal smear including three patients with invasive cervical squamous cell carcinoma detected on pap smear test. This study shows that routine pap smear screening in patients attending gynecological OPD is the good method of detecting precancerous cervical intraepithelial neoplasia (CIN) lesion and early cervical cancer, which would go undiagnosed otherwise with worst morbidity and mortality. We should try to cover 100% screening if possible in an institution at least to begin with.